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AVP of Claims, Fraud & Financial Crimes - Life, Health & Annuities

$195.23k - $351.41k

USAA - United Services Automobile Association

Why USAA?At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs.The OpportunityUSAA Life Insurance Company is seeking an accomplished and transformational insurance leader to serve as its next AVP of Claims, Fraud & Financial Crimes, a newly elevated leadership role responsible for shaping the future of claims administration and financial crime prevention across the Life, Health, and Annuity businesses.Reporting directly to the Vice President of LifeCo Operations, this executive will lead the teams responsible for Claims and the Special Investigations Unit (SIU), with end-to-end accountability for claims administration, complex claim adjudication, fraud prevention and investigation, Anti-Money Laundering (AML), financial crimes, and the operational controls that protect USAA Life Company and its members.Claims represents one of the most important moments in the relationship between an insurer and its policyholders. This leader will be responsible for ensuring that claims are handled with speed, accuracy, empathy, and integrity, delivering on USAA's promise to members while maintaining the rigorous controls required to protect the financial strength and reputation of the organization. The mandate spans routine claims through highly complex and contestable matters requiring deeper investigation, medical record review, fraud assessment, legal interpretation, and regulatory expertise.The opportunity extends well beyond administering claims. This executive will lead the continued evolution of USAA Life's fraud detection, investigation, AML, and financial crimes capabilities, bringing greater sophistication to how emerging risks are identified, assessed, investigated, and mitigated. The leader will strengthen the connection between Claims and SIU while leveraging data, analytics, technology, and process improvement to identify suspicious activity earlier, improve investigative effectiveness, and make sound, consistent decisions.Equally important, the executive in this role will establish the operating strategies, governance, performance disciplines, and controls required to deliver exceptional outcomes across Life Insurance, Health Insurance, and Annuities. Partnering closely with Operations, Legal, Compliance, Enterprise Risk, Product Management, and Technology, this leader will continuously strengthen claims processes while balancing member experience, regulatory obligations, fraud prevention, operational efficiency, and financial stewardship.For an accomplished insurance executive, this is a unique opportunity to lead at the intersection of claims, customer experience, risk, and financial crime prevention. The successful leader will inherit experienced teams while having the mandate to elevate their capabilities, modernize how claims and investigations are managed, and ensure USAA continues to deliver for members when they need the organization most.Additional OverviewThe AVP, Claims, Fraud & Financial Crimes is responsible for leading the execution, oversight, and continuous improvement of USAA Life Company's claims administration, fraud prevention, anti-money laundering (AML), and financial crimes programs across Life Insurance, Health Insurance, and Annuity products. This leader oversees claim operations, complex claim adjudication, fraud risk management activities, regulatory compliance, and operational controls to ensure claims are processed accurately, efficiently, and in accordance with applicable regulatory requirements. The role partners closely with Operations, Legal, Compliance, Enterprise Risk, Product Management, and Technology teams to deliver exceptional member experiences while protecting the financial integrity and reputation of USAA Life Company. The AVP champions operational excellence, risk management, process improvement, and data-driven decision-making while leading teams responsible for claims governance, fraud detection and investigation, financial crime prevention, and member-centric claims resolution practices.LocationUSAA offers a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX; Charlotte, NC; Phoenix, AZ. Relocation assistance is available for this position.What You'll DoClaims Operations & GovernanceLead the execution and continual enhancement of claims programs, policies, procedures, and operational practices across Life Insurance, Health Insurance, and Annuity products.Ensure claims processes balance member advocacy, regulatory compliance, operational efficiency, and financial stewardship.Oversee the investigation, evaluation, adjudication, and resolution of complex, contestable, and sensitive claims.Maintain governance frameworks, operational controls, and quality standards to ensure consistency and accuracy of claims decisions.Identify opportunities to improve claims processes, service delivery, and member outcomes through process optimization and technology enablement.Complex Claims OversightProvide leadership and decision authority for the most complex, high-risk, contestable, and high-value claims, including settlements exceeding established authority limits.Partner with Legal, Medical, Compliance, and Risk stakeholders to evaluate claims involving elevated legal, regulatory, financial, or reputational risk.Review emerging claims trends and operational metrics to identify opportunities for improved outcomes and risk mitigation.Ensure timely and fair claim resolution while maintaining adherence to regulatory requirements and internal standards.Fraud & Financial Crimes ManagementLead fraud prevention, detection, investigation, and reporting programs supporting Life Company products and services.Oversee fraud governance, monitoring activities, investigative processes, and case management practices designed to protect members and the organization from financial loss.Drive implementation of fraud risk management strategies and control frameworks that address operational, business, and financial risks.Partner with Enterprise Fraud, Compliance, Legal, and Risk Management teams to strengthen fraud prevention capabilities and ensure regulatory compliance.Monitor emerging fraud threats, industry trends, and evolving financial crime risks and develop recommendations to enhance program effectiveness.Anti-Money Laundering (AML) & ComplianceServe as the primary Life Company leader responsible for execution and oversight of AML programs and related regulatory requirements.Ensure compliance with applicable Bank Secrecy Act (BSA), AML, fraud, and insurance regulatory requirements.Partner with Enterprise Compliance, Legal, and Risk partners to implement AML policies, standards, and controls within Life Company operations.Maintain awareness of regulatory developments impacting claims, fraud, AML, and financial crimes programs.Support regulatory examinations, audits, and reviews and ensures timely remediation of identified issues.Risk Management & Regulatory SupportIdentify, assess, monitor, and escalate operational, regulatory, compliance, and reputational risks associated with claims and fraud activities.Collaborate with business partners to implement effective risk mitigation strategies and sustainable control environments.Support interactions with state insurance departments, regulatory agencies, external auditors, and internal governance forums.Ensure operational practices remain aligned with applicable laws, regulations, and company policies.Data Analytics & Process ExcellenceUtilize operational metrics, analytics, and performance data to improve claims outcomes, fraud detection effectiveness, member satisfaction, and operational efficiency.Lead continuous improvement initiatives focused on enhancing quality, productivity, compliance, and service delivery.Partner with Technology and Operations teams to implement automation, workflow improvements, and innovative solutions that improve organizational performance.Establish and monitor performance indicators that support effective management of claims and fraud operations.Leadership & Talent DevelopmentLead, develop, and inspire high-performing teams through coaching, mentoring, performance management, and career development.Create a culture of accountability, collaboration, operational excellence, and continuous learning.Build organizational capabilities needed to support business growth, evolving risks, and increasing regulatory expectations.Oversee workforce planning, succession planning, and employee engagement initiatives for assigned teams.What You HaveBachelor's degree, or 4 additional years of related experience beyond the minimum required may be substituted in lieu of a degree.10+ years of progressive experience across Life Insurance claims, fraud prevention, financial crimes, risk management, and/or related insurance operations.6+ years of leadership experience building and leading claims, SIU/fraud, financial crimes, risk, compliance, or complex operational teams.Deep knowledge of Life Insurance, Health Insurance, and/or Annuity claims administration, including the regulatory, operational, and customer considerations associated with complex claims.Demonstrated experience managing contestable claims, complex investigations, high-risk settlements, and claims involving potential fraud or material misrepresentation.Strong knowledge of fraud prevention, investigative practices, AML, financial crimes, operational risk, and associated governance and control frameworks.Proven ability to strengthen claims and investigative operations through process improvement, data and analytics, automation, technology, and disciplined performance management.Experience establishing and monitoring performance standards across claims quality, accuracy, cycle time, productivity, customer experience, investigative effectiveness, and financial outcomes.Experience working effectively with state insurance regulators, auditors, Compliance, Legal, Risk, and other control partners in highly regulated environments.Demonstrated ability to balance member advocacy with investigative rigor, regulatory requirements, sound risk management, and financial stewardship.Strong executive presence with the ability to influence senior stakeholders and drive complex decisions across a highly matrixed organization.Exceptional analytical, problem-solving, communication, and judgment skills, particularly when navigating complex or sensitive claims and investigative matters.What Sets You ApartDeep leadership experience within a prominent Life Insurance organization, with end-to-end accountability for large-scale claims operations and a strong understanding of the policyholder journey, regulatory environment, and unique complexities of life claims.Broad claims expertise across Life Insurance, Annuities, and/or Health Insurance, including significant experience with complex and contestable claims, beneficiary disputes, medical record reviews, high-risk settlements, and sensitive member or beneficiary situations.Demonstrated leadership of Special Investigations, fraud prevention, and financial crimes capabilities, with hands-on experience strengthening investigation, detection, escalation, and control frameworks while protecting both policyholders and the financial integrity of the organization.Proven success modernizing claims and investigative operations through process redesign, data and analytics, automation, and technology, materially improving claim accuracy, cycle times, investigative effectiveness, member experience, and operational efficiency.A track record of leading large, multi-layered Claims and Special Investigations organizations, developing strong leaders while creating a culture that balances member advocacy and empathy with investigative rigor, sound judgment, accountability, and disciplined risk management.Extensive experience partnering with Legal, Compliance, Risk, regulators, and other control functions on complex claims, fraud, AML, and financial crime matters, with the executive judgment to navigate situations carrying significant regulatory, financial, and reputational implications.Visa SponsorshipUSAA does not provide visa sponsorship for this position. Please do not apply for this position if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.). CompensationThe salary range for this position is $195,230 to $351,410.Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position.Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.Long Term Incentive Plan: Cash payment for Executive level roles only, representing a cash payment which is both time and performance based.Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.SummaryLocation: San Antonio Home Office I; Charlotte, NC - CENTS; Phoenix Campus (Main)Type: Full time

Vacancy posted 4 days ago
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